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Caring for a Family Member with Heart Failure

Caring for a Family Member with Heart Failure

Special Feature by Bret A. Witter, MD, FACC FACP

There are various types of heart failure. The most common form is congestive heart failure which is characterized by shortness of breath and often is worse when lying down at night. It is also frequently associated with swelling in the legs. The condition is a challenge for the patient and family. There are physical limitations and significant emotional changes.

Four areas of support can substantially improve a patient's outcome and quality of life.

First, diet. Most forms of heart failure are sensitive to salt. The average American diet is very high in sodium. A conservative guide would be to consume less than 2000 mg of sodium a day and in some patients this restriction needs to be more severe. Having high salt foods around the house is very challenging to avoid-especially snack foods such as chips, salted nuts and cheese. Many doctors recommend that patients weigh themselves daily to help monitor sodium and rapid water/salt retention. Early detection of water retention can prevent recurrent hospitalizations.

Secondly, medications are important. Many have been definitively shown to prolong life and reduce symptoms. Heart failure is often evident in the elderly and in patients with multiple noncardiac medications. It can be very difficult to take medications properly even in the best of circumstances. Many heart failure patients need to be on at least four medications for their heart alone. Pill boxes which are set up one week in advance can be very effective. It is common to forget if a medication has been taken without some effective reminder. It is a good idea to be aware of what medications affect blood pressure, heart rate and water retention.

Thirdly, regular physical activity is often beneficial and can improve heart failure symptoms. This is usually encouraged, but only with the guidance of the patient's personal physician. In some types of heart failure, the early stages of an exercise program may be monitored in the hospital setting. Many patients are discouraged by a description of the heart being “weak”. Even if the heart strength does not improve, regular activity can improve the body's ability to compensate and perform more activities without symptoms.

Finally, emotional support is very important. It is common for cardiac patients to become depressed and focus on what they can no longer do. Often, it is beneficial to focus on what can still be done. Cardiac patients often have “good” and “bad days”. A goal should be to maximize the good days.

Heart failure is a challenging disease for patients and their families. Fortunately, even simple changes in lifestyle or medication can be a very effective in maximizing “good” days at home.

Heart failure is a challenging disease for patients and their families. Fortunately, even simple changes in lifestyle or medication can be a very effective in maximizing “good” days at home.

This article was written by Bret A. Witter, MD, FACC, FACP. Dr. Witter is board certified in Internal Medicine, Cardiovascular Diseases and Cardiac Echocardiography. In addition to his full-time duties as a cardiologist and partner at Los Alamitos Cardiovascular, Dr. Witter is Assistant Clinical Professor at the David Geffen School of Medicine University of California, Los Angeles (UCLA). Learn more about Dr. Witter.

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